Individual provider Active NPI

Wendy Courtnage Tilleman, APRN, FNP-BC

  • Family Nurse Practitioner
  • Box Elder, MT
National Provider Identifier
1487829180
Registry record updated Oct 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NUR-APRN-LIC-177081 Issued in MT
Practice address
6850 Upper Ox Elder Road
Box Elder, MT 59521-9797
Phone
(406) 395-4486
Fax
(406) 395-5850
NPI assigned
Apr 24, 2008
Last updated
Oct 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NUR-APRN-LIC-177081 MT Primary
Registered Nurse 163W00000X RN25483 MT

Addresses

Primary practice location

6850 Upper Ox Elder Road
Box Elder, MT 59521-9797

Mailing address

6850 Upper Box Elder Rd
Box Elder, MT 59521-9073
Phone (406) 395-4486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220126001535 MT Practitioner - Nurse Practitioner 4183016025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rocky Boy Health CenterGroup PAC ID 4082508122, 8 clinicians

Practice addresses (Care Compare)

6850 Upper Box Elder Rd
Box Elder, MT 59521-9073
Phone (406) 395-4486

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN25483MTMDRegistered Nurse
NUR-APRN-LIC-177081MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Boy Health Center CurrentSince Aug 31, 2021 Accepting new patients

Locations

6850 Upper Box Elder Rd
Box Elder, MT 59521
Phone (406) 395-4374

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633651200000",
    "number": "1487829180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6850 UPPER BOX ELDER RD",
            "city": "BOX ELDER",
            "state": "MT",
            "postal_code": "595219073",
            "telephone_number": "406-395-4486",
            "fax_number": "406-395-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6850 UPPER OX ELDER ROAD",
            "city": "BOX ELDER",
            "state": "MT",
            "postal_code": "595219797",
            "telephone_number": "406-395-4486",
            "fax_number": "406-395-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILLEMAN",
        "first_name": "WENDY",
        "middle_name": "COURTNAGE",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2021-10-08",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-177081",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MT",
            "license": "RN25483",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Box Elder, MT

Sources for this page

Verify at the official NPI Registry.